Ethan Lopez, DO is a medicare enrolled "Internal Medicine" physician in Pleasanton, Texas. He went to Lake Erie College Of Osteopathic Medicine, Erie and graduated in 2017 and has 7 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Conviva Medical Center Management Of Texas, P.a. and his current practice location is
1030 Bensdale Rd, Pleasanton, Texas. You can reach out to his office (for appointments etc.) via phone at
(830) 569-6615.
Ethan Lopez is licensed to practice in Texas (license number R9644) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1649703513.
Physician's Profile
| Full Name | Ethan Lopez |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Experience | 7 Years |
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| Location | 1030 Bensdale Rd, Pleasanton, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ethan Lopez attended and graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2017
NPI Data:
- NPI Number: 1649703513
- Provider Enumeration Date: 04/07/2017
- Last Update Date: 07/22/2020
Medicare PECOS Information:
- PECOS PAC ID: 8527481415
- Enrollment ID: I20200710001710
Medical Identifiers
Medical identifiers for Ethan Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1649703513 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | R9644 (Texas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Conviva Medical Center Management Of Texas, P.a. | 8729302278 | 91 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Lopez allows following entities to bill medicare on his behalf.
| Entity Name | Amistad Community Health Center Incorporated |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386770147
PECOS PAC ID: 8527131036
Enrollment ID: O20100405000142 |
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| Entity Name | Conviva Medical Center Management Of Texas, P.a. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770988990
PECOS PAC ID: 8729302278
Enrollment ID: O20150112000488 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Lopez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ethan Lopez, DO
1030 Bensdale Rd,
Pleasanton, TX 78064-2037
Ph: (830) 569-6615 | Ethan Lopez, DO
1030 Bensdale Rd,
Pleasanton, TX 78064-2037
Ph: (830) 569-6615 |
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